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Diagnostic and treatment algorithm for chronic nodular prurigo.
Journal of the American Academy of Dermatology ( IF 13.8 ) Pub Date : 2019-07-13 , DOI: 10.1016/j.jaad.2019.07.022
Hartmut F Ständer 1 , Sarina Elmariah 2 , Claudia Zeidler 3 , Mary Spellman 4 , Sonja Ständer 3
Affiliation  

Chronic nodular prurigo (CNPG) is a subtype of chronic prurigo, also called prurigo nodularis, and a chronic skin condition characterized by intensely pruritic nodular lesions. Although the exact cause of CNPG is unknown, it appears to result from a repetitive itch-scratch cycle induced by neuronal sensitization to chronic pruritus. CNPG is associated with an underlying dermatologic condition in about half of patients, and it can also be attributed to systemic, neurologic, psychogenic, or unknown causes. For most patients, multiple underlying causes are identified. Patients with CNPG often experience impaired quality of life, sleep disturbance, anxiety, and depression. To encourage consistent and accurate diagnosis and treatment of CNPG across regions, we are proposing a diagnostic and treatment algorithm that includes initial assessment of core symptoms, detailed dermatologic history and clinical examination, patient-reported outcomes, diagnostic workup, and recommended therapies. This information is supplemented with photographs to illustrate clinical appearance and disease severity. Because CNPG is often multifactorial and it can take months to years for lesions to heal, interdisciplinary cooperation and long-term management are important.

中文翻译:

慢性结节性瘙痒症的诊断和治疗算法。

慢性结节性瘙痒症(CNPG)是慢性瘙痒症的一种亚型,也称为结节性瘙痒病,是一种以严重瘙痒性结节性病变为特征的慢性皮肤病。尽管尚不清楚CNPG的确切病因,但它似乎是由对慢性瘙痒的神经元敏化作用引起的反复瘙痒抓痒循环引起的。CNPG在大约一半的患者中与潜在的皮肤病相关,并且还可以归因于全身性,神经性,心理性或未知原因。对于大多数患者,确定了多种潜在原因。CNPG患者通常会经历生活质量下降,睡眠障碍,焦虑和抑郁。为了鼓励在各个地区对CNPG进行一致,准确的诊断和治疗,我们正在提出一种诊断和治疗算法,包括对核心症状的初步评估,详细的皮肤病史和临床检查,患者报告的结局,诊断检查和推荐的治疗方法。此信息还附有照片,以说明临床外观和疾病严重程度。由于CNPG通常是多因素的,并且病变可能要花数月至数年才能治愈,因此跨学科合作和长期管理很重要。
更新日期:2020-01-11
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